Dr. Rogers is assistant professor at the Massachusetts College of Pharmacy in Manchester, N.H. His interests are in psychopharmacology, infectious disease and pain management. He is a board-certified pharmacotherapeutic specialist and practices at Elliot Hospital. He has indicated he has nothing to disclose regarding the nature of this article.

The human immunodeficiency virus was identified in 1984 as the organism responsible for the development of the acquired immune deficiency syndrome known as AIDS. This syndrome, identified three years prior, leaves the host's immune system defenseless. As a result, infected individuals become prone to opportunistic infections, which eventually lead to their demise. Although the virus continues to be problematic, great strides have been made in identifying and treating its presence. In 1985 an extremely accurate blood test became commercially available to aid in diagnosing individuals who were infected with HIV and in screening blood-supply products. Two years later the first antiretroviral agent (zidovudine or AZT [Retrovir]) was approved by the U.S. Food and Drug Administration and, since then, over 20 other products have been added to the armamentarium.

In the mid 1990s, the combination of antiretroviral agents began to extend the life expectancy of HIV-infected patients. The combination of such medications has been termed highly active antiretroviral therapy (HAART) and generally consists of at least three agents. The goal of HAART is to keep the virus at bay by minimizing its levels within the bloodstream and thereby decreasing its effects on the immune system. Unfortunately, the immune system and the bloodstream are not the only sites in which the virus resides.